A NATION CHALLENGED: NEW YORK

A NATION CHALLENGED: NEW YORK; Flu Shots Are Encouraged To Reduce Anthrax Fear

By JENNIFER STEINHAUER

Published: October 25, 2001

Mayor Rudolph W. Giuliani went beyond the usual recommendations of the Centers for Disease Control and Prevention yesterday by urging all New Yorkers to get a flu shot, in part so that they do not confuse flu symptoms with those of inhalation anthrax.

''The symptoms of the flu and the early symptoms for anthrax are very similar,'' Mr. Giuliani said, on the same day that it was discovered that a second employee of The New York Post had probably contracted an anthrax infection of the skin. The employee, whom health officials did not identify, handled a letter that was believed to have possibly infected Johanna Huden, an assistant to the editorial page editor. She was treated with antibiotics for fever and an infected finger that she found out weeks later resulted from exposure to anthrax.

Health officials said there were no other confirmed cases yesterday. As a precaution, though, the offices of the F.B.I. and the United States Attorney in Manhattan planned to have tests conducted in their buildings.

Marvin Smilon, a spokesman for United States Attorney Mary Jo White, said the testing, which will be performed by the F.B.I., ''is part of the precautionary measures being taken at a number of government buildings in New York and elsewhere.''

Most recently, Ms. White's office prosecuted four followers of Osama bin Laden on charges that they conspired in the 1998 bombings of two American embassies in East Africa, which killed 224 people.

In urging New Yorkers to get flu shots, Mr. Giuliani sat down and rolled up his sleeve to get his own shot. The mayor noted that thousands of people get the flu each year, and that the fewer number of people who confuse the symptoms of the two illnesses, the better.

''All of those people present the possibility of creating a lot of confusion in looking for an anthrax case,'' he said. ''So it's good for you to get a flu shot and it's really good for the city. You'll help reduce the needle-in-a-haystack situation that can go on in trying to figure out what the symptoms are all about.''

Anthrax illness begins with symptoms usually associated with the flu -- fever, lack of energy, and muscle aches -- but inhalation anthrax then manifests itself with severe breathing problems and shock.

Generally, the C.D.C. recommends that the first set of people who should get a flu shot are health care workers, people over the age of 65 and those over six months with compromised immune systems. This was particularly true last year when there were shortages of the vaccine. This season, according to the C.D.C., manufacturers have said that there will be more supply, but that there will be a delay in the delivery of some of it.

The C.D.C. has requested that those who fall into the higher risk groups get the first shots and that everyone else wait until November when the supplies are more plentiful. But yesterday, the city's health commissioner, Dr. Neal L. Cohen, echoed the mayor's suggestions. ''If we can just transfer some of the anxiety that people feel unnecessarily about their possible exposure to anthrax or bioterrorism and do something very health preventive and positive, such as getting a flu shot, we'll see a lot of value in new York City,'' Dr. Cohen said.

The Post employee had a skin biopsy yesterday and was already taking antibiotics as a precaution, said Sandra Mullin, a spokeswoman for the city's Health Department. She added that various people around the city have had skin biopsies that are being analyzed, but she would not elaborate.

''The Department of Health and F.B.I. are conducting a full investigation of our workplace,'' said Ken Chandler, the newspaper's publisher. ''They have traced the path of the suspicious letter and identified all who may have come in contact with it.''

The city and the C.D.C. have chosen to announce anthrax cases only when they have been confirmed. Further, Stephen M. Ostroff, chief epidemiologist at the National Center for Infectious Diseases and the lead federal health investigator on the New York cases, has made a concerted effort to play down the risk of others who work in the companies where anthrax has been discovered.

Yesterday, he declined to say why he ordered 7,000 postal workers in New York to take antibiotics. ''We've been in constant consultation with the Postal Service over the past several days and have helped guide, in a collaborative fashion, decision-making about what would or wouldn't be done,'' Dr. Ostroff said.

When pressed about his recommendation, he added, ''It's not an issue of whether it was my recommendation to them or vice versa.''

Dr. Cohen then explained that the city did not want to find itself in the same position as Washington and Trenton, where postal workers were sickened and even died after what officials now concede was a delayed public health response to the danger they faced handling contaminated envelopes. ''We saw that the events that took place in Trenton and Washington to postal workers exceeded an acceptable level of protection to those postal workers,'' Dr. Cohen said. ''We don't want to see that happen here in New York City, certainly.''

Mayor Giuliani yesterday also encouraged New Yorkers who have a family member missing to bring personal items in for possible DNA matching, as only half have done so far, and tried as gently as he could to say that body parts are the only remains likely to be found in the rubble. ''I'm trying to find the right way to describe this,'' he said. ''What we're recovering are parts of bodies, that's -- so I don't want to offer a great deal of hope that we're going to be able to recover bodies in the way that people ordinarily think of that.''

He added: ''If we had a full range of DNA samples for virtually everybody, we could probably do a lot of matching and therefore be able to return something to the families that very much want that. But I can't give people hope that we're going to find lots of bodies. I have no reason to believe that.''